The Markey Cancer Center at the University of Kentucky, in collaboration with its key consortium affiliates (Pennsylvania State University and West Virginia University), regional partners and community-based cancer control coalitions, proposes the establishment of the Appalachia Cancer Network (ACN). The ACN will address critical cancer control issues that impact the rural, medically underserved population of Appalachia in the states of West Virginia, Kentucky, Tennessee, Virginia, Ohio, Pennsylvania, Maryland, and New York. The ACN will expand career control awareness within the rural, medically underserved, and minority populations of Appalachia, and through research and cancer control activities will address the key barriers to utilization of cancer control services and optimal cancer care within the Appalachian region. The long-term goals of the ACN program are to reduce cancer incidence and mortality and prevent future increases; reduces barriers to accessing cancer control services and programs (national, state and local) and increase utilization of such services; increase cancer survival; and stimulate greater coordination and participation among regional, state, and community cancer control networks throughout Appalachia. Program objectives: expand upon current ALIC project infrastructure to create an integrated network of cancer control partners throughout Appalachia; develop and implement regional, state and local cancer control interventions focusing on prevention and treatment for cancers of the breast, cervix, colon/rectum and lung; increase understanding of barriers to greater participation in clinical trials, as perceived by health care institutions and organizations, health care providers and Appalachian residents; increase community awareness of clinical trials, as well as recruitment to and retention in such trials; test the effectiveness of innovative CAN interventions developed by the program to address its targeted objectives; enhance and expand regional data collection and research efforts in Appalachia; serve as a bridge between NCI and community-based research, by increasing RO1 and other grant submissions to NIH/NCI from participating institutions and other partners and by increasing the number of scientists from the region that address cancer control issues.